Home Drug Guide Betamethasone Dipropionate and Clotrimazole

Drug Guide

Generic Name

Betamethasone Dipropionate and Clotrimazole

Brand Names Lotrisone, Clotrimazole and Betamethasone Dipropionate

Classification

Therapeutic: Topical antifungal and corticosteroid combination

Pharmacological: Betamethasone Dipropionate: corticosteroid; Clotrimazole: antifungal (azoles)

FDA Approved Indications

  • Treatment of superifical fungal infections of the skin (e.g., tinea, candidiasis) with associated inflammation and itching

Mechanism of Action

Betamethasone Dipropionate reduces inflammation, swelling, and itching by suppressing multiple inflammatory cytokines. Clotrimazole inhibits fungal cytochrome P450 enzyme 14α-demethylase, impairing ergosterol synthesis vital for fungal cell membrane integrity, leading to cell death.

Dosage and Administration

Adult: Apply a thin layer to affected area twice daily. Use for no more than 2 weeks unless directed by a healthcare provider.

Pediatric: Use with caution; safety and efficacy in children under 17 years have not been established.

Geriatric: No specific adjustments; monitor closely for skin thinning or adverse effects.

Renal Impairment: No specific adjustments, as the drug is topical.

Hepatic Impairment: No specific adjustments.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically, but absorption increases with large surface areas or compromised skin.

Distribution: Widespread distribution possible if absorbed systemically.

Metabolism: Betamethasone is metabolized in the liver; Clotrimazole is extensively metabolized in the liver.

Excretion: Metabolites excreted primarily via urine and bile.

Half Life: Betamethasone: approximately 36-54 hours; Clotrimazole: variable, as it is extensively metabolized.

Contraindications

  • Hypersensitivity to betamethasone, clotrimazole, or any component of the formulation.
  • Viral skin infections (e.g., herpes simplex, vaccinia).

Precautions

  • Use with caution in areas with broken or ulcerated skin, or on sensitive skin areas such as face, groin, or underarms. Avoid prolonged use to prevent skin atrophy.

Adverse Reactions - Common

  • Burning or itching at application site (Common)
  • Skin irritation or allergic contact dermatitis (Common)

Adverse Reactions - Serious

  • Skin atrophy, striae, telangiectasia with prolonged use (Uncommon)
  • Secondary infection due to immunosuppression (Uncommon)

Drug-Drug Interactions

  • None significant with topical use

Drug-Food Interactions

  • None

Drug-Herb Interactions

  • Caution with products that may irritate skin or alter absorption

Nursing Implications

Assessment: Inspect skin before and during therapy for signs of irritation or infection.

Diagnoses:

  • Risk of skin atrophy, secondary infection, adverse reaction.

Implementation: Apply thin layer, do not occlude unless instructed, avoid covering with tight bandages.

Evaluation: Monitor skin response and patient safety.

Patient/Family Teaching

  • Use only as directed; do not cover treated areas unless instructed.
  • Avoid contact with eyes, mouth, or mucous membranes.
  • Report any signs of irritation, worsening infection, or other adverse effects.

Special Considerations

Black Box Warnings:

  • Chronic use of topical corticosteroids can lead to skin atrophy, hypothalamic-pituitary-adrenal (HPA) axis suppression

Genetic Factors: No specific genetic considerations.

Lab Test Interference: None reported.

Overdose Management

Signs/Symptoms: Overuse can cause systemic corticosteroid effects such as HPA axis suppression, dermatologic thinning.

Treatment: Discontinue use, supportive care, monitor for adrenal suppression.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Keep out of reach of children.

Stability: Stable for the duration of labeling when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.